Over at the Chicago crime-writer blog collective The Outfit, Kevin Guilfoile has word that Hans Peterson's trial for the murder of Dr. David Cornbleet began yesterday in Guadalupe, where he's being tried by the French government. Guilfoile, a novelist (Cast of Shadows is excellent), actually beat the non-fiction press to real scoops about the trial, including the first published photo of Peterson and some Internet postings by the accused that will likely have some bearing on the case.
You might remember the case from back in 2006: a dermatologist was found stabbed to death in his high-rise office across the street from Millennium Park. It's no wonder it grabbed the attention of Guilfoile and his colleagues at The Outfit, since it unfolded like an episode of Law & Order, specifically an "issue" episode: a highly regarded doctor with no known enemies and a stable family life is killed; security footage reveals a hooded man, holding a bloody piece of fabric to his face; the video blankets local and national television and the Internet, in a Web 2.0 investigation led by the family of the victim; the case cracks open when Peterson's former roommate outs him in a MySpace message; and the motive turns out to be not jealousy or greed but Peterson's belief that a popular, controversial acne medication prescribed by Cornbleet ruined the suspect's life.
In 2007, Chicago's Bryan Smith wrote what, near as I can tell, is the definitive account of the Peterson case, "Bloodlines." It tells the story from the perspective of the son of the murdered doctor and the father of the accused, himself a doctor. It's an empathetic piece, which outlines the ongoing psychological problems Peterson suffered, a gifted student who was worked an options job in Chicago and attended the Cardozo School of Law in New York before his life was derailed:
When Hans reached his high-school years, however, a sense of melancholy began to show itself. "He started getting more and more shy or being more and more aware of being shy," the father says. "When you get to be teenagers, all the little social structure starts. And since he wasn't the kind of person who easily engaged people in conversation, he kind of felt left out of things. Not that people didn't like him. He was very likable and everyone was fine having him around, but he wasn't in the in crowd. He didn't have much of a social life and he didn't date much" beyond taking McIntosh's daughter to the prom.
The father says he was concerned enough about the depression to take his son to a therapist. "He'd get into a pretty blue mood where he didn't want to do anything," the father says. "As he got more and more into teenage years, you started seeing it more and more, to the point when he was 16 he got put on antidepressants [Zoloft] for the first time." By then Tom and Jackie Peterson were having their own troubles. They divorced in 1994.
His grades were up and down, depending on his depressive moods. "He would get a 3.8 one semester and a 2.6 the next," his father says. When he would come home for visits, he would sleep until noon, a fact that concerned his dad. "It was like he did not want to get up and do the day. He didn't really care what he had to eat."
It's sad, but not in and of itself particularly unusual. All of that could apply to me at different points in my life, which is probably why Smith's article got to me. And that's where the acne medication, Accutane, comes in:
Roche Pharmaceuticals has also admitted that Accutane can cause depression, psychosis, and, in rare instances, thoughts of suicide. Indeed, a product information insert included with the drug warns patients to stop Accutane if they or a family member notices symptoms of depression or psychosis. Those symptoms include the patient's becoming more "irritable or aggressive" than usual, or "acting on dangerous impulses."
Peterson only took the drug for two days, four years before the murder. But it was enough for him to latch onto Accutane as a cause for his mental and physical problems. As Guilfoile wrote after finding Peterson's Internet trail:
More than 60 posts from Hans follow over the next five years. They show a man becoming increasingly obsessed with the drug Accutane and the effects he believed it was having on his body and his mind. He attributes a series of ailments, including depression, to the medication but the two that he claims most haunt him are a constant ringing in his ears and a loss of sexual sensation.
It's a difficult case: the side effects of Accutane are contested. Meanwhile, Peterson has a long history of serious if not permanently debilitating mental illness, and it's not clear from anything I've read whether or not Peterson was under any treatment for his psychological and physical ailments while in New York, something that will likely come out in this week's trial. When dealing with psychotropic medications, the line between the effects of the medication itself and psychosomatic effects—belief, really—is a fine one:
But during her final visit to the institute, one of the doctors directing the research sat her down to deliver some disturbing news. "He told me I hadn't been taking a medicine at all. I'd been on a placebo. I was totally shocked." So was nurse Abrams. Both women knew that half the test subjects were getting placebos and that Schonfeld might be among them. But not only was she feeling better — she'd even experienced nausea, a side effect commonly associated with Effexor, so they had each assumed that she was in the drug group. Schonfeld was so certain of this that at first she didn't believe the doctor. "I said to him, 'Are you sure? Check those records again.'" But there was no doubt. The brown bag contained nothing but sugar pills. Which didn't mean, he was quick to add, that she was making anything up, but only that her improvement couldn't possibly be due to the pharmacological effects of the pills.
Psychiatrists and other mental-health professionals (I am a practicing therapist) know that any given antidepressant has only about a 50 percent chance of working with any given person. But what most people — patients and clinicians alike — don't know is that in more than half of the 47 trials used by the Food and Drug Administration to approve the six leading antidepressants on the market, the drugs failed to outperform sugar pills, and in the trials that were successful, the advantage of drugs over placebo was slight.
Did the Accutane permanently damage Peterson's brain? Or could it have been a reverse placebo, the putative dangers of Accutane being caused by Peterson's belief in them? As Guilfoile points out, the Accutane defense failed in the case of John Mullarkey, an 18-year-old who killed his girlfriend; he was convicted in two hours.